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Last Updated: Oct 27, 2026
Practice Management Tips
Client questionnaire template: Free PDF and what to include
Free PDF 3 pages, print-ready Clinician-reviewed
A client questionnaire is the intake form a new patient completes before a first appointment. It covers contact details, medical and family history, medications, allergies, the reason for the visit, and lifestyle habits. This free template gives your team that structure in a printable PDF, with an optional feedback page for after the visit. Adapt the questions to your specialty, then send the form digitally so answers arrive before the patient does. This guide covers what to include, how to adapt the form, how to send it, and what data protection law asks of you.
Template details
- Template type
- Questionnaire
- Format
- Printable PDF, 3 pages
- Sections
- 1 section
- Fields to complete
- 38 fields
- Best for
- Practice Management Tips
Free download
Download your free client questionnaire template
An intake form covering contact details, medical and family history, medications, allergies, the reason for the visit, symptom severity, and lifestyle habits. It ends with a clinician notes box and an optional post-visit feedback section with a signature line.
What’s inside
- Personal and contact details, including preferred contact method and an emergency contact
- Medical history covering chronic conditions, dated surgeries or hospital stays, and family conditions
- Current medications, supplements and allergies, each listed in its own field
- Reason for visit, overall health, current symptoms and a 1–10 severity scale
- Lifestyle questions on smoking, alcohol, exercise, diet, pregnancy and breastfeeding
- Clinician notes box, plus an optional post-visit feedback section with signature line
Generate it. Send it. File it automatically.
Turn this template into a Smart Form
Start from scratch, or upload this PDF or any form you already use, and Pabau's AI Form rebuilds it with tick boxes, text fields and a signature. Attach it to the treatment once, and every patient gets it on time.
- Generate with AI from a PDF, Word file or photo
- Precare before the visit, aftercare after checkout
- Signed forms saved to the patient record
Why practices run their forms on Pabau
Bring your forms across fast
AI Form rebuilds the consent, history and aftercare forms you already use. You review each one, then publish.
Save hours every week
Patients complete forms on their phone before they arrive, so the front desk stops retyping paper.
Stay audit-ready
Every signed form is versioned and attached to the treatment record, ready when you need it.
Ask patients once
Set how long a consent stays valid. Returning patients skip forms they have already signed.
Supports HIPAA and GDPR compliance AES-256 encryption 4.8 on G2 4.7 on Capterra Trusted by 4,000+ practices worldwide
Key takeaways
A client questionnaire gives every new patient the same core intake questions before the first appointment.
The template covers contact details, medical and family history, medications, allergies, the reason for the visit, and lifestyle habits.
Its last page is an optional post-visit feedback section, so decide whether to keep it, split it off, or delete it.
Health data is special category data under UK GDPR, so add a privacy notice and limit who can see the answers.
Sending the form digitally at booking means clinicians read the answers before the patient arrives.
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What is a client questionnaire?
A client questionnaire is an intake form that collects the information a practice needs before a patient’s first consultation.
A general business questionnaire asks about preferences. A healthcare or aesthetic version also asks about medication, allergies, and contraindications, so the answers carry clinical weight.
Common mistake: Sending one generic form to every patient. A med spa and a primary care practice need different questions, so adapt the template before you send it.
Which practices use it
Any practice that books new patients for a consultation or treatment can use it, but the questions should shift by setting.
- Med spas and aesthetic practices that need skin history, previous treatments, and contraindications before injectables or laser work.
- Private practices and primary care providers that want medical history collected before the first appointment.
- Wellness and integrative practices that gather lifestyle factors and patient goals.
- Mental health practices that want a structured, consistent first contact.
What to include in an intake questionnaire
A complete form covers five areas. The table below shows what each one captures and why it matters.
The template’s family history question is brief, so practices that need more detail can add a family medical history form. Aesthetic practices usually add sun exposure and skincare questions to the lifestyle section.
Record consent separately, with a signed medical consent form for each treatment. For more on the paperwork healthcare teams use, see medical forms in healthcare practices.
How to adapt and use the template
Five steps turn the template into a working part of your intake process.
- Remove questions you never act on, then add treatment-specific questions for your highest-volume services.
- Check that the medical sections match the treatments you offer, especially injectables and laser work.
- Send the form at booking, so patients have time to complete it before their appointment.
- Review responses before the consultation, and flag contraindications or medication queries to the clinician.
- File the completed form in the patient record, and set a review date each year.
Build your edits around the template’s sections: personal details, medical history, the reason for the visit, and lifestyle habits. Clinicians make the final call on what to ask and how to read the answers.
Benefits of standardized intake
The main benefit is consistency. Every new patient receives the same core questions, so intake doesn’t depend on who is on reception that day.
Clinicians start each consultation with context, so the appointment can focus on the patient’s concerns instead of basic history.
Pro Tip
Audit the form once a year against the services you offer. Pull a sample of recent completed forms and remove questions nobody reads or acts on. Shorter forms tend to get finished, and clinicians read the answers that remain.
Sending the questionnaire digitally
Paper forms slow check-in and make answers hard to search. A digital form fixes both, because patients complete it at home and the answers arrive already typed.
- Send the form at booking, then once more a few days before the appointment.
- Use a short reminder message that explains why the form matters.
- Set a deadline, and call patients who haven’t completed it.
Data protection rules for health information
Health information is special category data under UK GDPR (Article 9). It needs an additional legal condition and tighter handling than ordinary contact details. The ICO’s UK GDPR guidance sets out the detail.
What to do: Add a clear privacy notice to the form, such as this questionnaire privacy statement. Then use a consent checkbox that explains what the patient agrees to, and set a retention period for records.
- Limit access to staff who need the information for care.
- Ask your software provider for its security documentation.
- Apply your retention policy consistently.
If you’re regulated by the Care Quality Commission (CQC) in England, its record-keeping expectations apply alongside data protection law. US practices should check their HIPAA obligations instead.
The optional post-visit feedback section
The template ends with a page marked for use after the appointment. It asks the patient to rate their care from 1 to 10 and add other feedback. It also asks whether they saw another provider for the same problem. A name, signature, and license number line closes the document.
That page measures how the patient felt after treatment, which is a different question from what they told you before it. The breakdown below shows which parts belong to each stage of the visit.
Send only the intake pages before the appointment, and hand over the feedback page once care is given. If you’d rather keep intake records clean, delete the page and run a separate satisfaction survey.
The CSQ-8 (Client Satisfaction Questionnaire, 8 items) is a validated instrument used in mental health and health services research, and it can inform that survey.
- How would you rate the consultation?
- Did your practitioner explain the treatment clearly?
- Did your results match what you were told to expect?
- What could we have done better?
How Pabau sends the questionnaire and files the answers
On paper, the questionnaire arrives at check-in, and someone retypes the answers into the patient file while the next patient waits.
Pabau, the practice management platform we build, sends the questionnaire as a digital form before the appointment. Patients complete it online, and the answers are stored against their record, so nobody re-enters them. Our intake software for practices handles forms, consents, and medical history in one place.
You can also set automated questionnaire workflows that send the form at booking. Before the consultation, Pabau Scribe, our AI scribe, summarizes the patient’s medical history and turns the conversation into structured notes.
Get questionnaires back before patients arrive
See how Pabau sends intake questionnaires at booking, collects the answers online, and files them in the patient record automatically.
Conclusion
A client questionnaire only helps if someone reads the answers before the patient sits down. Trim the template to the questions your clinicians act on, add the treatment-specific ones you need, and send it at booking.
Decide early what happens to the feedback page. Kept in the same document, it needs a separate send after the visit. Split off, it keeps the intake record clean and still gives you an honest view of the care you gave.
Book a demo to see how Pabau sends your questionnaire at booking and files every answer in the patient record.
Continue your research
Want to greet new patients before they arrive? New patient welcome letter template shows what to send alongside the questionnaire, and when.
Moving consent online as well? E-consent form covers what to include and how to send it digitally.
Need a structured clinical follow-up to intake? Medical review of systems gives clinicians a body-system checklist to work through in the consultation.
Documenting the full first assessment? History and physical form records the history and examination findings that follow the questionnaire.
Frequently asked questions
What is the difference between a client questionnaire and a client intake form?
A client intake form records administrative details, such as who the patient is and how to reach them. A client questionnaire asks the clinical and lifestyle questions that shape treatment. Many practices combine both in one document, as this template does.
Can I download a free client questionnaire template as a PDF?
Yes. The download button on this page links to a PDF of the template. Print it, or save it and adapt the questions in your own document.
How often should the questionnaire be reviewed?
Review it at least once a year, and after any change to your treatments, consent wording, or data protection policy.
What should an aesthetic practice add to the form?
Add questions on skin type, previous aesthetic treatments, sun exposure, and the patient’s current skincare routine. Keep the template’s medication, allergy, and pregnancy questions, because they flag contraindications.
How do I get patients to complete it before the appointment?
Send it when the appointment is booked, remind the patient a few days before, and set a clear deadline for completion.
Should the post-visit feedback section stay in the same form?
It can, but only if your team sends that page after the appointment. Otherwise, delete it and send a separate satisfaction survey once treatment is done.
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